Legal

The feds are getting serious about cracking down on Medicare fraud.

Medicare permits participation by practice site so that you can participate and accept Medicare 100% of the time at one location and not another.

The U.S. Department of Health and Human Services (HHS) sent a message last week that it is serious about violations of the Health Insurance Portability and Accountability Act (HIPAA), hitting a major hospital and medical group with more than $5 million in fines and penalties.

Letters discuss congressional issues, electronic health records, and partnerships versus solo practices.

CMS is coming under harsh criticism from the AAFP for not doing more to ensure that primary care doctors are appropriately valued and reimbursed.

The publisher of The Wall Street Journal filed court papers in late January to overturn a 21-year-old court injunction that blocks public access to information in the Medicare physician payment payment database.

The U.S. Senate passed an amendment to the healthcare reform legislation to repeal the requirement for small businesses, including physician practices, to file an IRS form 1099 for each vendor from whom they make purchases of $600 or more.

The healthcare quality organization that sets the health insurance industry-accepted criteria for practices being recognized as a patient-centered medical home released updated guidelines on January 31.

The legal world lost a great cross-examiner when Steven I. Kern, JD, passed away January 10. And Medical Economics lost a great columnist.

The government is continuing its commitment to stopping fraud by instituting more advanced screening and prevention techniques as part of the Patient Protection and Affordable Care Act.

Thanks to greater federal funding and loosened state eligibility requirements, the number of patients receiving healthcare coverage through Medicaid and Children's Health Insurance Program has grown in recent years, according to a new study.

If you see patients in the hospital, it's important to realize that clinical language does not necessarily equate to coding language.

Looking into the future, the author sees storm clouds and tsunami waves ahead on the ocean of healthcare.

The American Academy of Family Physicians, the American College of Physicians and the American Medical Association were among the 100 medical and physician organizations that sent a supportive letter to the sponsors of HR 5, a medical liability reform bill introduced in January.

An advisory team to the Vermont legislature recommends that the state switch to a single-payer system managed by an independent board and claims processor as the best option to cover all of its residents and control costs.

Despite the predictions of many pundits, Congress' "lame duck" session was productive after all: Among other accomplishments, the long-awaited tax cuts are now law, at least through 2012.

Congress has delayed primary care's Medicare reimbursement cut for another year. Rather that this being cause for celebration, however, it simply represents the reality that had the cut gone through, there wouldn't be much incentive to stay in the practice of medicine-and Congress knows that.

Although the recently passed legislation that creates a 1-year extension of current Medicare physician payment rates is a step up from the series of shorter-term patches witnessed during 2010, it is "only one step toward a permanent solution to the flawed sustainable growth rate formula that threatens deep Medicare payment cuts and the financial viability of primary care physician practices," according to Roland Goertz, MD, president, American Academy of Family Physicians.

Medical societies representing the 50 states and the District of Columbia and 57 national medical specialty societies have requested that the Centers for Medicare and Medicaid Services use the $200 million from Congress to provide physicians with overdue Medicare reimbursements for payments that they should have received in 2010.

Learn whether Medicare is paying for preventive services, how to bill for meningococcal vaccine, as well as coding for Medicare Advantage plans.

Americans remain divided over the nation's healthcare reform package, with 40% of adults wanting to repeal all or most of the legislation while 31% favor keeping all or most of the reforms, and 29% uncertain, according to results of a poll.

The U.S. Congress passed a bill in December that exempts doctors, nurse practitioners, and non-medical professionals from the Federal Trade Commission's "Red Flags" Rule, which helps protect consumers from identity theft.

Congress voted in late November to halt a 23% payment cut that was to take effect this month to physicians who accept Medicare.

The Centers for Medicare and Medicaid Services launched a division last month charged with testing "new ways of delivering healthcare and paying healthcare providers that can save money for Medicare and Medicaid while improving quality of care," including the patient-centered medical homes, according to CMS.

Learn the appropriate codes that you can use for reporting the monitoring of warfarin dosage for certain patients.

Nearly 7 out of 10 practices are likely to limit the number of new Medicare patients they accept unless Congress halts upcoming Medicare reimbursement cuts set to take place on December 1 and January 1, according to survey results of the MGMA.

The Joint Commission is developing standards to designate its accredited ambulatory healthcare organizations with a "Primary Care Home" status.

The elimination of reimbursement for consultation codes has impacted physician revenue greatly, in some instances. Learn how to address this in your practice.

The Patient Protection and Affordable Care Act includes an element that could have a significant impact on physicians-not as medical providers, but as small business owners.

Medical practices that have implemented an electronic health record system report better financial performance than those that have not, according to the Medical Group Management Association?s newly released Electronic Health Records Impacts on Revenue, Costs, and Staffing: 2010 Report Based on 2009 Data.